Hemorrhage and thromboses associated with neoplastic disorders

Thrombosis and hemorrhage constitute systemic manifestations of neoplastic disease. Thrombosis may be caused by alteration in platelet adhesiveness, release of thromboplastic material, increased antihemophilic globulin content, diminished antifibrinolytic activity and dysproteinemias, such as cryofibrinogenemia or cryoglobulinemia. Increased hemorrhagic tendency in cancer is due to thrombocytopenia, hypofibrinogenemia (either with or without fibrinolysis), anticoagulants, and dysproteinemias. The same mechanism for the production of a thrombotic state can predispose, under certain circumstances, to a hemorrhagic state. The mechanisms whereby the hematologic abnormalities produce clinical symptomatology have been detailed. In our present state of knowledge, the explanation for some of the phenomena remains a mystery.